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中国防痨杂志 ›› 2002, Vol. 24 ›› Issue (1): 16-18.

• 论著 • 上一篇    下一篇

经纤维支气管镜局部给药对耐多药肺结核病的治疗研究

张瑞娥；张崎；鲁宏武；党丽云；曹思哲；   

  1. 西安市结核病胸部肿瘤医院 西安 710061；
  • 出版日期:2002-01-10 发布日期:2002-11-03

A study on the treatment of multi-drug resistant pulmonary tuberculosis with bronchofiberscope and catheter intervention after basified local environment

ZHANG Rui-e,ZHANG Qi,Li Hong-wu,et al.   

  1. Xi’an Tuberculosis and Thoracic Tumor Hospital,Xi’an 710061
  • Online:2002-01-10 Published:2002-11-03

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摘要： 目的　评价纤维支气管镜 (纤支镜 )局部给药配合全身化疗对耐多药肺结核病的治疗效果。方法 将纤支镜导至病灶区或相应的段支气管 ,清除病灶分泌物后 ,再注入4%碳酸氢钠、丁胺卡那霉素(A)、氧氟沙星(O)、异烟肼(H)注射液 ,配合全身化疗治疗耐多药肺结核44例 ,与单纯全身化疗30例进行对照研究。结果 经纤支镜给药治疗组满9个月时痰菌阴转率93.2% ,病灶有效率90.9% ,空洞闭合率40.5%。均显著高于单纯全身化疗组的60.0% ,56.7%及16.1% (P＜0.01,P＜0.05)。结论 经纤支镜给药配合全身化疗治疗耐多药肺结核病 ,疗效显著优于单纯全身化疗 ,而且未见严重的并发症和毒副反应。

关键词: 结核,肺/药物疗法, 抗药性, 纤维支气管镜, 导管插入术, 碱化环境

Abstract: Objective To study the efficacy of brochofiberscope and catheter intervention combined with chemotherapy in the treatment of multi-drug resistant pulmonary tuberculosis (MDR-TB).Methods 44 cases were treated by injecting amikacin,ofloxacin and isoniazid,after cleaning up exudation and bacifing local environment with NaHCO 3 through brochofiberscope and catheter combined with chemotherapy,while 30 controls were treated by chemotherapy only.Results By the end of 9 months,the sputum tubercle bacillus conversion rate,radiagraphical improvement rate and cavity closing rate were 93.2%?90.9% and 40.5% respectively in the treated groups,while all these indications were higher than control group 60%?56.7% and 16.1% (P＜0.01,P＜0.05).No complications and obvious adverse reactions were observed.Conclusion Brochofiberscope and catheter intervention combined with chemotherapy is safe and more effective than simple chemotherapy in the treatment of MDR-TB.

Key words: Tuberculosis,pulmonary/Drug therapy, Drug resistant, Bronchofiber scope, Catheterization, Basification evnironment

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